Middle Tennessee State University MSN Program Clinical/Student Requirements- Admission to MSN Program The following are required documents that MUST be uploaded in Medatrax prior to beginning the MSN program. Please submit all documents in a Word or.pdf format only. We will not accept the.jpeg format. *Those students who do not complete these requirements will not be allowed to register for courses. All forms are located at http://mtsu.edu/nursing/forms.php Student Authorization to Release Information Registered Nurse Licensure Students must hold and maintain a current unencumbered license to practice as a Registered Nurse in Tennessee. A copy of this license must be uploaded to Medatrax. Student Liability Insurance The graduate student practices under his or her own license and is required to maintain current advanced practice student liability insurance. Family Nurse Practitioner students must maintain student FNP liability insurance in the amount of $1,000,000/$6,000,000. This policy also applies to federal employees, including active military who engage in a clinical practicum regardless of setting. A general Registered Nurse Liability Policy does not meet this requirement. Middle Tennessee State University School of Nursing has negotiated group rates for this coverage at a very reasonable rate. Please contact MSNadvisor@MTSU.edu for details. All MSN students must purchase Liability Insurance through the MTSU School of Nursing A copy of current FNP student liability insurance must be uploaded to Medatrax. 1
Health History, Physical Examination and Immunization Requirements All students must document physical and emotional fitness to meet the essential requirements of the program. A current MSN Health History Form is required and must be uploaded in Medatrax. Please submit all five (5) pages of this document. Immunization Requirements (to be completed by an MD, NP or PA) MMR (Measles, Mumps, Rubella) Measles, Mumps, Rubella). Evidence of immunity for healthcare providers includes: documented evidence of two doses at least 28 days apart * documentation of positive titers presumptive evidence of immunity to measles, mumps and rubella for individuals born prior to 1957. Vaccinations and titers are not required for persons in this age group. Varicella (Chicken Pox) varicella (chicken pox). Evidence of immunity for healthcare providers includes: written documentation of vaccination with 2 doses of varicella vaccine laboratory evidence of immunity or laboratory confirmation of disease diagnosis or verification of a history of varicella disease by a healthcare provider diagnosis or verification of a history of Herpes Zoster (HZ) by a healthcare provider In the absence of above documentation, students are required to obtain a varicella titer. If titer is negative, the student is required to get the vaccine and a follow-up titer is required. 2
Hepatitis B Hepatitis B. Evidence of immunity for healthcare providers includes: documentation of positive titers submission of completed and signed Hepatitis B Waiver form. Tetanus Tetanus. Evidence of immunity for healthcare providers includes: documentation of Tdap booster received in past 10 years Tuberculin Tests Tuberculosis. Evidence of immunity for healthcare providers includes: Documentation of initial two-step tuberculin skin test given 1-3 weeks apart. If two-step is negative, one-step TB is required annually*. Documentation must include actual administration and reading of two (2) TB skin tests within the appropriate time frame. Annual TB skin testing does not meet the two-step requirement. If positive, medical evaluation and documentation of a clear chest x-ray prior to admission to clinical site and annual completion of the Annual Past-Positive TB Screening Form confirming the absence of symptoms by a healthcare provider. If there is evidence of a positive chest x-ray and/or symptoms of TB, please followup for medical evaluation. *TB blood tests also called interferon-gamma release assays or IGRAs may be substituted upon validation by a healthcare provider for the two step or annual TB skin test. Note that small or rural clinics may not accept these results. Two IGRAs are approved by the US Food and Drug Administration (FDA): QuantiFERON - TB Gold In-Tube test (QFT-GIT) T-SPOT TB test (T-Spot) * An initial two-step TB skin test within the timeframe noted above is required for all students. ** 3
Influenza Students must provide written documentation confirming proof of vaccine. Evidence of vaccination for healthcare providers includes: one dose of TIV (trivalent) or LAIV (live attenuated) annual vaccination (highly recommended) or signed Influenza Waiver Form to decline seasonal flu vaccine. Note: Many clinical agencies are requiring evidence of annual vaccination or the wearing of a mask during flu season. Clinical/Student Requirements- Start of Clinical Experiences The following are required documents that MUST be uploaded in Medatrax prior to beginning of clinical courses. *Those students who do not complete these requirements will not be allowed to register for clinical courses* Background Checks A full Criminal Background Check (CBC) via TrueScreen is required and must be completed within 90 days of your first clinical preceptorship. Proof that a Criminal Background Check was obtained must be uploaded in Medatrax prior to being admitted to your first preceptorship. It is the student s responsibility to make timely arrangements for the background check and to pay all costs associated with such checks. You must keep a copy of the background check for your records AND you are required to send a copy the School of Nursing. Please send your background check to Mrs. Grace James at MSNadvisor@MTSU.edu Drug Screen A 10-panel urine drug screen is required and must be completed within 30 days of your first clinical preceptorship. If you are taking prescription medication, please take it with you to the test in the original bottle. Any positive tests will be shared with the clinical agency and your attendance will be at the agency s discretion. 4
The drug screen may be completed at any healthcare provider or walk in clinic and sent to Mrs. Grace James at MSNAdvisor@mtsu.edu and a copy uploaded to Medatrax. A student may be required to complete an additional drug screen as requested by the clinical agency. HIPAA & OSHA Safety Training (required annually) Prior to starting your first clinical/practicum experience, and on an annual basis you must complete and verify completion of the HIPAA and OSHA/Infection Control/Hazardous Materials training. To complete the training: http://mtsu.edu/nursing/forms/msnhipaatrainingoshainfectioncontrol.pdf Please upload evidence of training into Medatrax. Name Tags Students must purchase and are required to wear name tags during their clinical preceptorship. Name tags can be purchased at an office supply company and should include the following information: Originated fall 2017 Clerical Updates 3/28/2018 Updated 8/6/2018 Student Name Middle Tennessee State University FNP Student 5
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